BC Emergency Departments Crisis!

BC Emergency Departments Crisis!

Many emergency departments are understaffed because the government is not hiring enough emergency room physicians. Many are chronically severely overcrowded with patients that belong on hospital wards!

The Problem, Consequences and Solution

The Problem

The Royal Columbian Hospital (RCH) Emergency Department (ED) has over 50 patient stretchers. However most of the ED stretchers are filled with admitted patients who deserve to be in hospital beds outside of the ED – this is hospital overcrowding. Because of this there few properly equipped areas available for incoming emergency patients. As a result, Emergency Physicians and Nurses have been forced to examine and provide care in inadequate and unsafe areas such as the waiting room, lobby, hallways. Examinations are delayed and incomplete. Medications are often delayed or not given due to lack of monitoring. There is no privacy for patients in the hallway. All of these problems are not because of a problem in the ED, but because the hospital is overcrowded, something that is not under the control of ED Staff.

Introduction of the 4-hour rule in Australia led to a reversal of overcrowding in three tertiary hospital EDs that coincided with a significant fall in the overall mortality rate in tertiary hospital data combined and in two of the three individual hospitals. ED overcrowding (as measured by 8-hour access block) at the tertiary hospitals improved dramatically, falling from above 40% in July 2009 to around 10% by early 2011, and presentations increased by 10%, while the mortality rate fell significantly (by 13%; 95% CI, 7%–18%; P < 0.001) from 1.12% to 0.98% between 2009–10 and 2010–11. Monthly mortality rates decreased significantly in two of the three tertiary hospitals concurrently with decreased access block and an increased proportion of patients admitted in under 4 hours.